Few for women sanitation

By Praveen Raman
In Health
December 11, 2015

Because of poverty and lack of awareness, majority of rural women do not use sanitary napkins and are vulnerable to many diseases

Abha Ekka, a student of sociology at the Ranchi University, till recently adheres to the belief that menstruation is ‘dirty’ and would avoid going to schools. But her thoughts changed when she moved to the capital city of Jharkhand some two years ago for higher education. Now, Abha doesn’t need to miss her classes during ‘those days’ as she is better prepared to deal with it, something that was not available at her village. Unfortunately, millions of girls of Jharkhand are not as lucky as Abha, they still use primitive methods during that time. In a country of 355 million menstruating girls and women, such problem is rampant.

There are many who are not so lucky. “Two-three days before I got my periods, I used to feel ill, thinking what to use during those days because there was no cotton cloth. Whenever I think about it, I get a headache. When my periods start I take anything from my house. I have spoilt cushions, pillow covers, bedsheet to use for periods. Due to that many times I have been scolded and even beaten up by my mother but what do I do? Once in anger I didn’t have food for two days. When I asked my classmate for pads, she said, these are not for free. These are very costly. She had got them from the market. I feel sick and often pray to God to stop my periods forever,” says Shalu, daughter of a Tangewala who lives in Saharanpur, Uttar Pradesh. Her father’s income is barely enough to meet the daily needs of the family. The unbearable trauma in Shalu’s words makes you think; if she had enough cloth, would menses still be a monthly disaster for her?

Girls in rural areas are exposed to diseases as they have no access to sanitary napkins and are not aware of its health implications. More than health, it also hurts education of girls as they avoid going to schools during that time. A plethora of large studies lay out the numbers – 23 per cent of girls drop out of school when they hit menarche, 31 percent of women miss 2.2 days of work when they menstruate, girls miss 20 per cent of school days every year while there is a 70 per cent increase in incidences of reproductive tract infections in the absence of menstrual hygiene.

A study focussed on 2,579 girls and women in slums in Madhya Pradesh, Chhattisgarh and Uttar Pradesh found out that while 89 per cent of respondents used cloth, with over half of them using the same cloth for more than one period, two per cent used cotton wool and the same numbers used ash to absorb menstrual flow while only seven per cent used sanitary pads.

There is a potential loss of about US $100 billion in GDP to India as a result of girls dropping out of school due to menstrual health issues and thus getting into early marriages and early pregnancies. More girls in schools means universal primary education and increased gender parity while contributing to eradication of poverty. Educated mothers also contribute to improved maternal health and reduction in child mortality – all of which figure in the Millennium Development Goals.

Lack of availability of sanitary towels has a profound economic effect on women. Women form a big share of rural work force. One study found that the majority of these women were using rags as menstrual cloths. Infections are so common in the women that they often fall sick.

There are two major causes of why girls and women in countries like India face harsh problems while menstruating. One is, predictably, the high poverty rates and the direct consequences associated with this. This includes poor infrastructure meaning lack of specialisation of domestic and public toilets for women.

In rural areas, there is shortage of latrines and when women are menstruating their problems are amplified. Also many low-earning women compromise on buying herself sanitary towels to buy food to provide for her family.

While the governments have taken various measures to provide sanitary napkins to poor girls and women, but the real fight is against the taboo attached with it. Our society must realise that mensuration is a normal biological process just like breathing and eating. Recently, the UP government has rolled out the Kishori Suraksha Yojana under which one pack of 10 sanitary napkins every month shall be handed out to all girl students in classes 6-12 in government and government aided schools.

This is just a beginning as there are more girls outside the government and aided schools who live under the dangers of health problems.

Women play an important role in rural economy; their well being is social well being. If there is no better environment for their health, the welfare of the society will have a setback and the availability of napkins is the first step towards ensuring proper sanitation to women.

Kirti Singh, a Ranchi-based gynaecologist points out lack of supportive environment to fight against it. She said, “A supportive environment needs to be created for girls to use sanitary napkins. How does the giving of sanitary napkins make a difference when there are no functional toilets in schools or where functional toilets have no water?”

Those are extremely valid considerations in a state where 64.7 per cent of all households do not have functional toilets and while official data says that only 2.99 per cent government schools and 10.32 per cent private schools do not have toilets, the reality of these is dismal.

While merely doling out sanitary napkins without awareness and supportive infrastructure is unlikely to make any long term difference, the mere idea of what currently mass produced pads will do to the environment is also worrisome.

Many organisations have been working towards adequate female sanitation facilities, and better awareness and understanding of menstruation.

Many organisations and initiatives help to reduce the problem through hygiene education, cheaper sanitary towels, and female public toilets. However, perhaps the stubborn social myths around menstruation, and cause so much distress to girls and women, are much tougher to get rid of.

Meenakshi Gupta, the co-founder of Delhi-based Goonj, points out the systematic flaw in the delivery system. While speaking to this magazine she says, “When you randomly ask women in villages how many sarees do you have?

The answer usually is 2-3. There isn’t enough cloth to even cover their bodies. Struggling with other more urgent needs like food, shelter and health, women tend to treat their own need for a clean piece of cloth for menses as the last priority. In any case, most think of menses as a symbol of dirt and something which needs to be only removed from the body.”

She also says that the lack of access to clean cloth pads or market products, inability to afford market napkins and the lack of awareness about the health and hygiene issues around menses are the three key reasons why women face a huge challenge in dealing with their menses in rural India.

The government can play a big role especially in spreading awareness about menses, to highlight it as a normal biological process. That would help break the strong culture of shame and silence around the issue. That is also the first challenge we face in addressing this issue.

mypad The New Delhi-based Goonj is using clean cotton cloth to manufacture sanitary pads for rural women and girls. Till date the organisation has distributed more than 30 lakh MY Pads across India that means more than 6 lakh sq. meter discarded cloth put to use. The pads are made avaulable at very low cost This is the cotton cloth they get from the cities; bed sheets, salwar-kamizes, cotton t-shirts etc. What makes it powerful is when Goonj uses these MY Pads as a tool for spreading awareness about the related health and hygiene issues. The model on which it works is very effective.